Statistical risk model

Percent of adult population aged 18+ years who were identified as having at least one of the following six chronic conditions: Asthma, Chronic Obstructive Pulmonary Disease (COPD), Coronary Artery Disease (CAD), Heart Failure (HF), Hypertension (HTN), or Diabetes Mellitus (DM), were followed for at least one-year, and had one or more potentially avoidable complications (PACs) during the most recent 12 months.

Brief Description of Measure: Percent of adult population aged 18+ years with Community Acquired Pneumonia who are followed for one-month, and have one or more potentially avoidable complication (PAC) during the episode time window. Please reference the attached document labeled NQF_PNE_all_codes_risk_adjustment_12_14_15.xls, in the tab labeled PACS I-9 & I-10 for a list of code definitions of PACs relevant to pneumonia.

In-hospital deaths per 1,000 pediatric heart surgery admissions among patients with congenital heart disease ages 17 years and younger.

Percentage of home health stays in which patients who had an acute inpatient hospitalization in the 5 days before the start of their home health stay were admitted to an acute care hospital during the 30 days following the start of the home health stay.

This is a hospital based, risk adjusted, case mix adjusted elderly surgery aggregate clinical outcomes measure of adults 65 years of age and older.

This is a hospital based, risk adjusted, case mix adjusted morbidity and mortality aggregate outcome measure of adults 18+ years undergoing colon surgery.

The Risk Adjusted Post-Ambulance Provider Triage Emergency Department (ED) Visit Rate Measure (shorthand: Post-Triage ED Visit Rate Measure) assesses the quality of the triage and decision making by ambulance providers who transport low acuity patients to an alternative destination (non-ED location), or facilitate Treatment In Place (TIP), by identifying whether patients have a subsequent ED visit or death within three days.

Risk adjusted, case mix adjusted urinary tract infection outcome measure of adults 18+ years after surgical procedure.

The Risk Standardized Mortality Ratio for Late-Stage CKD and ESRD is an outcome measure to assess how well providers prevent mortality among patients with stage 4 or 5 CKD or ESRD. This measure assesses nephrology practices who care for adult Medicare Fee-for-Service (FFS) beneficiaries with late-stage CKD and ESRD.

The average (geometric mean) hospital length of stay in days relative to the expected geometric mean length of stay of any well defined population of inpatients over a specified time interval